Pub Date : 2024-05-10DOI: 10.33667/2078-5631-2024-7-55-59
O. A. Tikhonova, D. Druzhinin, L. Litvinova, S. Doktorova, N. Todosenko, N. D. Gazatova, M. Bograya, E. L. Naumova, M. I. Dolgaleva
Recently, the role of vitamin imbalance in carcinogenesis has been actively discussed. Studies aimed at assessing their role in the processes of cancer development are various, and the evaluation of the initial level of vitamins is relevant when planning antitumor therapy.Objective. To determine the state of the initial level of B vitamins and homocysteine before chemotherapy in patients of different oncologic profile.Material sand Methods. The level of vitamins B1, B6, B9, active form of B12* and homocysteine in fresh frozen plasma was determined by enzyme[1]linked immunosorbent assay (ELISA) using test systems in 66 patients with verified malignant neoplasms before chemotherapy. The study included 66 patients: women n=40 and men n=26, with cancer: gastric n=12, colorectal cancer n=21, cancer lung n=11, cancer pelvic organs n=22.Results. According to the results of the study the increase in the level of holotranscobalamin (Holo-TC) and decrease in homocysteine in comparison with reference values was observed in 100% of cases. Significant difference was found only for B1: reliable differences between patients with colorectal cancer and with pelvic cancer (in the latter the mean value of B1 levels was 2.4 times higher at p = 0.0425). According to the results of correlation analysis, a weak correlation between B12 and B9 was determined. When comparing the levels of vitamin B12 and homocysteine in patients after surgical treatment and without it, no significant differences were found.Conclusion. Increased Holo-TC levels and decreased homocysteine levels by ELISA are characteristic of all varieties of solid cancer, independent of sex, age, stage and previous surgical intervention. A relative decrease in vitamin B1 is characteristic of colorectal cancer
最近,人们积极讨论了维生素失衡在致癌过程中的作用。旨在评估维生素在癌症发展过程中的作用的研究多种多样,在计划抗肿瘤治疗时,对维生素初始水平的评估具有重要意义。确定不同肿瘤患者化疗前 B 族维生素和同型半胱氨酸的初始水平。采用酶[1]联免疫吸附试验(ELISA)测定化疗前新鲜冰冻血浆中维生素B1、B6、B9、活性形式B12*和同型半胱氨酸的水平。该研究包括66名患者:女性40人,男性26人,癌症:胃癌12人,结直肠癌21人,肺癌11人,盆腔器官癌22人。研究结果表明,与参考值相比,100% 的病例中全反式钴胺素(Holo-TC)水平有所上升,同型半胱氨酸水平有所下降。只有 B1 存在显著差异:结直肠癌患者和盆腔癌患者之间存在可靠的差异(盆腔癌患者的 B1 水平平均值是结直肠癌患者的 2.4 倍,P = 0.0425)。根据相关性分析结果,B12 和 B9 之间存在微弱的相关性。在比较手术治疗后和未手术治疗患者的维生素 B12 和同型半胱氨酸水平时,未发现明显差异。通过酶联免疫吸附试验(ELISA)发现,所有类型的实体瘤都有全维生素 T C 水平升高和同型半胱氨酸水平降低的特征,与性别、年龄、分期和既往手术治疗无关。维生素 B1 的相对减少是结直肠癌的特征。
{"title":"B vitamins and homocysteine in cancer patients with solid malignancies before chemotherapy administration","authors":"O. A. Tikhonova, D. Druzhinin, L. Litvinova, S. Doktorova, N. Todosenko, N. D. Gazatova, M. Bograya, E. L. Naumova, M. I. Dolgaleva","doi":"10.33667/2078-5631-2024-7-55-59","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-55-59","url":null,"abstract":"Recently, the role of vitamin imbalance in carcinogenesis has been actively discussed. Studies aimed at assessing their role in the processes of cancer development are various, and the evaluation of the initial level of vitamins is relevant when planning antitumor therapy.Objective. To determine the state of the initial level of B vitamins and homocysteine before chemotherapy in patients of different oncologic profile.Material sand Methods. The level of vitamins B1, B6, B9, active form of B12* and homocysteine in fresh frozen plasma was determined by enzyme[1]linked immunosorbent assay (ELISA) using test systems in 66 patients with verified malignant neoplasms before chemotherapy. The study included 66 patients: women n=40 and men n=26, with cancer: gastric n=12, colorectal cancer n=21, cancer lung n=11, cancer pelvic organs n=22.Results. According to the results of the study the increase in the level of holotranscobalamin (Holo-TC) and decrease in homocysteine in comparison with reference values was observed in 100% of cases. Significant difference was found only for B1: reliable differences between patients with colorectal cancer and with pelvic cancer (in the latter the mean value of B1 levels was 2.4 times higher at p = 0.0425). According to the results of correlation analysis, a weak correlation between B12 and B9 was determined. When comparing the levels of vitamin B12 and homocysteine in patients after surgical treatment and without it, no significant differences were found.Conclusion. Increased Holo-TC levels and decreased homocysteine levels by ELISA are characteristic of all varieties of solid cancer, independent of sex, age, stage and previous surgical intervention. A relative decrease in vitamin B1 is characteristic of colorectal cancer","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-10DOI: 10.33667/2078-5631-2024-8-22-24
A. B. Khuraseva, T. V. Reminnaya
{"title":"The prevalence of vaginal dysbiosis in women of reproductive age","authors":"A. B. Khuraseva, T. V. Reminnaya","doi":"10.33667/2078-5631-2024-8-22-24","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-8-22-24","url":null,"abstract":"","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-6-39-46
A. Frolov, I. Manichev, S. Ermolaeva
Yoga breathing exercises that develop the ability to voluntarily regulate the minute volume of respiration (MV) and maintain the state of hypoventilation, hypoxia and hypercapnia, can be considered as a way of hypoxic-hypercapnic training, potentially capable of influencing cerebral circulation and neuroprotective factors. However, at the moment, individual anthropometric features that affect the ability to develop a hypoventilation mode of breathing have not been studied, and methodological criteria for training have not been developed.Methods: The study involved 44 people (32 men and 12 women) who regularly practice yoga breathing techniques with a voluntary decrease in respiratory rate using maximum tidal volume (TV). Free breathing was recorded for 2 minutes, then each subject performed the respiratory hypoventilation pattern available to him or her (minimum RR values with maximum TV, inhalation and exhalation were of equal duration). The following parameters of external respiration were determined: respiratory rate (RR), minute ventilation (MV), tidal volume (TV), partial pressure of CO2 in the exhaled air at the end of exhalation (PetCO2 ), percentage of O2 in the exhaled air (FeO2) and hemoglobin saturation (SpO2 ).Results: Compared to breathing at rest (MV = M±SD 8.51 ± 2.57 (95% CI 7.72–9.29) l/min; PetCO2 = M±SD 36.98 ± 3.71 (95% CI 35.85–38.11) mm Hg), the mode with RR = 3 times/min (inspiration and expiration for 10 s), n = 44, leads to an increase in MV up to M±SD 12.02 ± 3.42 (95% CI 10.98–13.06) l/min (p < 0.001) and a decrease of CO2 : PetCO2 = M±SD 33.99 ± 3.59 (95% CI 32.90–35.08) mm Hg (p < 0.001) — that is, to development of alveolar hypocapnia. The mode with RR = 1.5 times/min (inhalation and exhalation for 20 s), n = 44, demonstrates a decrease in MV to M±SD 5.95 ± 1.59 (95% CI 5.46–6.43) l/min (p < 0.001) and growth of PetCO2 up to M±SD 41.19 ± 3.71 (95% CI 40.06–42.32) mm Hg (p < 0.001). The mode with RR = 1 time/min (inspiration and exhalation for 30 s), n = 24: with a decrease in RR to 1 time/min, a decrease in MV was observed to M±SD 4.22 ± 0.92 (95% CI 3.83–4.61) l / min (p < 0.001) and an increase in PetCO2 up to M±SD 44.05 ± 3.05 (95% CI 42.76–45.33) mm Hg (p < 0.001). The breathing pattern with RR = 1 r/min is accompanied by a statistically significant decrease in MV compared to rest, as well as an increase in PetCO2 and a decrease in FeO2 , that is, it is hypoventilation. We have proposed a ventilation coefficient (Qvent), which is the ratio MV/VC, which allows us to judge at what values of MV an individual reaches a state of hypoventilation. It was previously shown in this sample that the breathing exercise becomes hypoventilation when Qvent values are equal to or less than 1. With Qvent in the range from 1 to 2, the ventilation mode is within normal values, and when Qvent is more than 2, hyperventilation occurs.Conclusion: when performing yoga breathing exercises, variations in MV are observed both in the directi
{"title":"Study of gas exchange under different modes of ventilation in yoga breathing exercises","authors":"A. Frolov, I. Manichev, S. Ermolaeva","doi":"10.33667/2078-5631-2024-6-39-46","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-6-39-46","url":null,"abstract":"Yoga breathing exercises that develop the ability to voluntarily regulate the minute volume of respiration (MV) and maintain the state of hypoventilation, hypoxia and hypercapnia, can be considered as a way of hypoxic-hypercapnic training, potentially capable of influencing cerebral circulation and neuroprotective factors. However, at the moment, individual anthropometric features that affect the ability to develop a hypoventilation mode of breathing have not been studied, and methodological criteria for training have not been developed.Methods: The study involved 44 people (32 men and 12 women) who regularly practice yoga breathing techniques with a voluntary decrease in respiratory rate using maximum tidal volume (TV). Free breathing was recorded for 2 minutes, then each subject performed the respiratory hypoventilation pattern available to him or her (minimum RR values with maximum TV, inhalation and exhalation were of equal duration). The following parameters of external respiration were determined: respiratory rate (RR), minute ventilation (MV), tidal volume (TV), partial pressure of CO2 in the exhaled air at the end of exhalation (PetCO2 ), percentage of O2 in the exhaled air (FeO2) and hemoglobin saturation (SpO2 ).Results: Compared to breathing at rest (MV = M±SD 8.51 ± 2.57 (95% CI 7.72–9.29) l/min; PetCO2 = M±SD 36.98 ± 3.71 (95% CI 35.85–38.11) mm Hg), the mode with RR = 3 times/min (inspiration and expiration for 10 s), n = 44, leads to an increase in MV up to M±SD 12.02 ± 3.42 (95% CI 10.98–13.06) l/min (p < 0.001) and a decrease of CO2 : PetCO2 = M±SD 33.99 ± 3.59 (95% CI 32.90–35.08) mm Hg (p < 0.001) — that is, to development of alveolar hypocapnia. The mode with RR = 1.5 times/min (inhalation and exhalation for 20 s), n = 44, demonstrates a decrease in MV to M±SD 5.95 ± 1.59 (95% CI 5.46–6.43) l/min (p < 0.001) and growth of PetCO2 up to M±SD 41.19 ± 3.71 (95% CI 40.06–42.32) mm Hg (p < 0.001). The mode with RR = 1 time/min (inspiration and exhalation for 30 s), n = 24: with a decrease in RR to 1 time/min, a decrease in MV was observed to M±SD 4.22 ± 0.92 (95% CI 3.83–4.61) l / min (p < 0.001) and an increase in PetCO2 up to M±SD 44.05 ± 3.05 (95% CI 42.76–45.33) mm Hg (p < 0.001). The breathing pattern with RR = 1 r/min is accompanied by a statistically significant decrease in MV compared to rest, as well as an increase in PetCO2 and a decrease in FeO2 , that is, it is hypoventilation. We have proposed a ventilation coefficient (Qvent), which is the ratio MV/VC, which allows us to judge at what values of MV an individual reaches a state of hypoventilation. It was previously shown in this sample that the breathing exercise becomes hypoventilation when Qvent values are equal to or less than 1. With Qvent in the range from 1 to 2, the ventilation mode is within normal values, and when Qvent is more than 2, hyperventilation occurs.Conclusion: when performing yoga breathing exercises, variations in MV are observed both in the directi","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-6-47-50
T. Kulagina, E. Dutikova, V. A. Sandrikov, A. V. Gavrilenko, Al-Samsei Naim Nas
It is assumed that the wall shear stress (WSS), which determines the function of the endothelium, is constant along the arterial bed. The assessment of turbulence, blood flow velocity in the arterial system in healthy (13 patients) and in patients with the initial form of atherosclerosis in the femoral artery (42 patients) was discussed. The study quantified blood flow in the common femoral artery using V Flow with visualization of blood flow with a high frame rate. The results obtained in the femoral arteries were evaluated by the wall shear rate, velocity profile and oscillation index (OSI). It was shown that the average value of WSSmean in the femoral artery in healthy and in patients with stenosis <30–35% is 0.9± 0.4 – 0.91±0.4 Pa and does not significantly differ. The wall thickness in the common femoral artery in patients with the initial form of atherosclerosis was 0.9–1.1 mm, and in healthy patients 0.8–0.9 mm. The correlation between the parameters was evaluated by nonparametric analysis of Kendall’s Taub. It was revealed that there is no correlation between WSSmean and blood flow velocity (Vs) in both healthy and patients with the initial form of atherosclerosis.
{"title":"Ultrasound vector mapping of common femoral artery blood flow in normal and early-stage stenosis","authors":"T. Kulagina, E. Dutikova, V. A. Sandrikov, A. V. Gavrilenko, Al-Samsei Naim Nas","doi":"10.33667/2078-5631-2024-6-47-50","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-6-47-50","url":null,"abstract":"It is assumed that the wall shear stress (WSS), which determines the function of the endothelium, is constant along the arterial bed. The assessment of turbulence, blood flow velocity in the arterial system in healthy (13 patients) and in patients with the initial form of atherosclerosis in the femoral artery (42 patients) was discussed. The study quantified blood flow in the common femoral artery using V Flow with visualization of blood flow with a high frame rate. The results obtained in the femoral arteries were evaluated by the wall shear rate, velocity profile and oscillation index (OSI). It was shown that the average value of WSSmean in the femoral artery in healthy and in patients with stenosis <30–35% is 0.9± 0.4 – 0.91±0.4 Pa and does not significantly differ. The wall thickness in the common femoral artery in patients with the initial form of atherosclerosis was 0.9–1.1 mm, and in healthy patients 0.8–0.9 mm. The correlation between the parameters was evaluated by nonparametric analysis of Kendall’s Taub. It was revealed that there is no correlation between WSSmean and blood flow velocity (Vs) in both healthy and patients with the initial form of atherosclerosis.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-8-8-12
A. A. Grigoryants
{"title":"Optimization of the method of introducing anti-adhesion gel “Аntiadhesin” during laparoscopic access in gynecology","authors":"A. A. Grigoryants","doi":"10.33667/2078-5631-2024-8-8-12","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-8-8-12","url":null,"abstract":"","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-7-7-12
E. Lubennikova, E. Artamonova
Adjuvant therapy with trastuzumab made a significant contribution to improving disease-free and overall survival rates in patients with HER2-positive breast cancer. However, in a number of clinical situations the risk of disease recurrence remains increased. Carrying out neoadjuvant treatment followed by post-neoadjuvant therapy, depending on the degree of pathomorphological response, is the modern standard, allowing to cure a significantly larger number of patients. This became possible thanks to the expansion of the arsenal of terget anti-Her drugs and the introduction into real clinical practice of double anti-HER2 blockade (trastuzumab + pertuzumab) and an antibody conjugate with a cytostatic drug – trastuzumab emtansine. To assess actual clinical practice in the Russian Federation, a survey study “Therapy of HER2-positive breast cancer” was conducted. The survey involved 50 specialists from different regions of the country who are directly involved in developing a treatment plan for patients, which allows them to reflect the preferences of leading chemotherapists regarding tactics for HER2-positive breast cancer. This publication reflects the results of part of the survey, devoted to the choice of adjuvant and post-neoadjuvant therapy for HER2-positive breast cancer. Identified a clear positive trend in favor of neoadjuvant treatment followed by post-neoadjuvant therapy using modern targeted drugs such as pertuzumab and trastuzumab emtansine. The survey results show that 68% of patients with RCB-II–III residual tumor receive post-neoadjuvant trastuzumab emtanzine, in 2021 this figure was only 24%. The absolute majority of patients who have not received neoadjuvant therapy, but have N2–3 stage, receive double anti-HER2 therapy with trastuzumab + pertuzumab in the adjuvant setting. High adherence to the therapy was noted, as 97% of patients complete the planned course of T-DM1, and 91.2% of patients complete a year of adjuvant anti-HER2 therapy. These figures are noticeably higher than the indicators of registration studies. Issues of effectiveness come to the fore in choosing therapy. Issues of drug availability remain relevant, but are not decisive. The survey also revealed factors that were not obvious at first glance and influenced treatment results.
{"title":"Choice of adjuvant therapy for HER2-positive breast cancer in real clinical practice: analysis of physician preferences in the Russian Federation","authors":"E. Lubennikova, E. Artamonova","doi":"10.33667/2078-5631-2024-7-7-12","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-7-12","url":null,"abstract":"Adjuvant therapy with trastuzumab made a significant contribution to improving disease-free and overall survival rates in patients with HER2-positive breast cancer. However, in a number of clinical situations the risk of disease recurrence remains increased. Carrying out neoadjuvant treatment followed by post-neoadjuvant therapy, depending on the degree of pathomorphological response, is the modern standard, allowing to cure a significantly larger number of patients. This became possible thanks to the expansion of the arsenal of terget anti-Her drugs and the introduction into real clinical practice of double anti-HER2 blockade (trastuzumab + pertuzumab) and an antibody conjugate with a cytostatic drug – trastuzumab emtansine. To assess actual clinical practice in the Russian Federation, a survey study “Therapy of HER2-positive breast cancer” was conducted. The survey involved 50 specialists from different regions of the country who are directly involved in developing a treatment plan for patients, which allows them to reflect the preferences of leading chemotherapists regarding tactics for HER2-positive breast cancer. This publication reflects the results of part of the survey, devoted to the choice of adjuvant and post-neoadjuvant therapy for HER2-positive breast cancer. Identified a clear positive trend in favor of neoadjuvant treatment followed by post-neoadjuvant therapy using modern targeted drugs such as pertuzumab and trastuzumab emtansine. The survey results show that 68% of patients with RCB-II–III residual tumor receive post-neoadjuvant trastuzumab emtanzine, in 2021 this figure was only 24%. The absolute majority of patients who have not received neoadjuvant therapy, but have N2–3 stage, receive double anti-HER2 therapy with trastuzumab + pertuzumab in the adjuvant setting. High adherence to the therapy was noted, as 97% of patients complete the planned course of T-DM1, and 91.2% of patients complete a year of adjuvant anti-HER2 therapy. These figures are noticeably higher than the indicators of registration studies. Issues of effectiveness come to the fore in choosing therapy. Issues of drug availability remain relevant, but are not decisive. The survey also revealed factors that were not obvious at first glance and influenced treatment results.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 46","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-8-13-15
L. Tkachenko, T. A. Verovskaya, N. I. Sviridova, T. I. Kostenko, E. A. Homich
The problem of non-developing pregnancy (NB) remains relevant due to the rather wide spread of this complication and is due to the search for prognostically significant causes of this pathology, the development of adequate prevention of the detected disorders [1–4]. Polymorphic variants of folate genes lead to excessive accumulation of HC in the blood and hypomethylation of DNA, which contributes to an increase in early miscarriage (the frequency of this pathology is 20–25% of all pregnancies). Carrying out periconceptional prophylaxis with high doses of folic acidreduces the level of free HC in the blood, but this technique is effective only when it begins 3 months before conception and in the early stages of embryo and fetus development (up to 12 weeks). The evaluation of laboratory and clinical data in the course of the study confirmed the effectiveness of the use of folic acid at a dose of 800 mcg in a high risk group for the development of NB (pregnant women with hyperhomocysteinemia (GHZ)) 16 weeks before conception and 12 weeks after conception.
不发育妊娠(NB)问题仍然具有现实意义,因为这种并发症的传播范围相当广泛,而且还需要寻找导致这种病症的重要预后原因,并对所发现的病症进行适当的预防[1-4]。叶酸基因的多态变异会导致血液中 HC 的过度积累和 DNA 的低甲基化,从而导致早期流产的增加(这种病症的发生率占所有妊娠的 20-25%)。使用大剂量叶酸进行围孕期预防可降低血液中游离 HC 的水平,但这种方法只有在受孕前 3 个月以及胚胎和胎儿发育早期(12 周内)开始使用时才有效。研究过程中对实验室和临床数据的评估证实,在 NB 高危人群(患有高同型半胱氨酸血症(GHZ)的孕妇)中使用剂量为 800 微克的叶酸是有效的。受孕前 16 周和受孕后 12 周。
{"title":"New in the prevention of undeveloped pregnanc","authors":"L. Tkachenko, T. A. Verovskaya, N. I. Sviridova, T. I. Kostenko, E. A. Homich","doi":"10.33667/2078-5631-2024-8-13-15","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-8-13-15","url":null,"abstract":"The problem of non-developing pregnancy (NB) remains relevant due to the rather wide spread of this complication and is due to the search for prognostically significant causes of this pathology, the development of adequate prevention of the detected disorders [1–4]. Polymorphic variants of folate genes lead to excessive accumulation of HC in the blood and hypomethylation of DNA, which contributes to an increase in early miscarriage (the frequency of this pathology is 20–25% of all pregnancies). Carrying out periconceptional prophylaxis with high doses of folic acidreduces the level of free HC in the blood, but this technique is effective only when it begins 3 months before conception and in the early stages of embryo and fetus development (up to 12 weeks). The evaluation of laboratory and clinical data in the course of the study confirmed the effectiveness of the use of folic acid at a dose of 800 mcg in a high risk group for the development of NB (pregnant women with hyperhomocysteinemia (GHZ)) 16 weeks before conception and 12 weeks after conception.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-7-18-25
R. Rakhimov, A. V. Sultanbaev, K. Menshikov, A. Nasretdinov, S. Musin, O. Lipatov, V. A. Suravatkin
Every year, 400,000 new cases of renal cell carcinoma (RCC) and 175,000 deaths are registered worldwide. Currently available advanced treatments for RCC have less toxicity than previously used therapeutic agents, but drug resistance remains a clinically significant problem. Drug resistance occurs as a result of angiogenic transition through activation of pathways that do not depend on VEGF targets of most first-line treatments. Lenvatinib with everolimus can fight resistance to increase both progression-free survival and overall survival in patients with metastatic RCC according to clinical studies.
{"title":"The effectiveness of the combination of lenvatinib and everolimus in metastatic renal cell carcinoma in patients with resistance to targeted treatment in real clinical practice","authors":"R. Rakhimov, A. V. Sultanbaev, K. Menshikov, A. Nasretdinov, S. Musin, O. Lipatov, V. A. Suravatkin","doi":"10.33667/2078-5631-2024-7-18-25","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-18-25","url":null,"abstract":"Every year, 400,000 new cases of renal cell carcinoma (RCC) and 175,000 deaths are registered worldwide. Currently available advanced treatments for RCC have less toxicity than previously used therapeutic agents, but drug resistance remains a clinically significant problem. Drug resistance occurs as a result of angiogenic transition through activation of pathways that do not depend on VEGF targets of most first-line treatments. Lenvatinib with everolimus can fight resistance to increase both progression-free survival and overall survival in patients with metastatic RCC according to clinical studies.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-7-34-40
A. O. Tagil, A. V. Borsukov
Relevance. Malignant neoplasms of the thyroid gland account for 1–3% in the structure of oncological pathology in the territory of the Russian Federation. Fine needle aspiration biopsy of thyroid foci is an integral part of the examination and is included in both foreign and domestic recommendations. However, there is a problem of obtaining uninformative cytological conclusions, and the risk of obtaining false positive and false negative results remains.Objective. To determine the possibilities of using vacuum aspiration fine needle biopsy under ultrasound control in patients with focal thyroid pathology in a multidisciplinary hospital.Materials and methods. From 2021 to 2023, 331 patients with focal thyroid pathology were examined at the clinical base of the Department of Diagnostic and Minimally Invasive Technologies of the Clinical Hospital № 1 in Smolensk. All patients were divided into two clinical groups. Patients of both groups underwent a comprehensive examination, including palpation of the thyroid gland and lymph nodes of the neck, multiparametric ultrasound examination of the thyroid gland, including B – mode, color Doppler mapping, compression elastography, shear wave elastography, laboratory examination (calcitonin level, TSH, T3, T4, antibodies of TPO, AtTTP, thyroglobulin). In patients who had previously undergone surgical treatment, ultrasound was performed to determine areas of thyroid tissue, and additionally the level of thyroglobulin was determined as a marker of the recurrent process.Results. The median size of the thyroid formation was 15.2 (13.9–19.1) mm. Mainly multiple foci of thyroid gland were detected in both the control group – 106 (79.1%) and the main 107 (54.3%) patients, the share of single foci accounted for 28 (20.9%) of the control and 90 (45.7%) of the main groups. Fine – needle aspiration biopsy was performed using the «Free hand» method using type syringe with a volume of 10 ml. During the vacuum fine – needle aspiration biopsy, depending on the data of the multiparametric ultrasound examination, the level of negative pressure in the range from –0.3 bar to –0.8 bar was determined. At a pressure of –0.3 bar, 54 (27.4%) were performed,–0.5 bar – 126 (64.0%),–0.8 bar – 17 (8.6%) vacuum fine – needle aspiration biopsy.Conclusions. A device has been developed for the implementation of vacuum fine – needle aspiration biopsy with the creation of an improved technique for conducting vacuum fine – needle aspiration biopsy in focal thyroid pathology. The informative value of the method of routine fine – needle aspiration biopsy and vacuum fine – needle aspiration biopsy under ultrasound control in patients with focal thyroid pathology was evaluated. The sensitivity and specificity of fine – needle aspiration biopsy was 75.0% and 52.9%, respectively. The sensitivity and specificity of vacuum fine – needle aspiration biopsy during the study were 95.6% and 92.5%, respectively. The data obtained indicate the effectiveness
{"title":"Vacuum fine-needle aspiration biopsy as a method of early detection of thyroid cancer","authors":"A. O. Tagil, A. V. Borsukov","doi":"10.33667/2078-5631-2024-7-34-40","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-34-40","url":null,"abstract":"Relevance. Malignant neoplasms of the thyroid gland account for 1–3% in the structure of oncological pathology in the territory of the Russian Federation. Fine needle aspiration biopsy of thyroid foci is an integral part of the examination and is included in both foreign and domestic recommendations. However, there is a problem of obtaining uninformative cytological conclusions, and the risk of obtaining false positive and false negative results remains.Objective. To determine the possibilities of using vacuum aspiration fine needle biopsy under ultrasound control in patients with focal thyroid pathology in a multidisciplinary hospital.Materials and methods. From 2021 to 2023, 331 patients with focal thyroid pathology were examined at the clinical base of the Department of Diagnostic and Minimally Invasive Technologies of the Clinical Hospital № 1 in Smolensk. All patients were divided into two clinical groups. Patients of both groups underwent a comprehensive examination, including palpation of the thyroid gland and lymph nodes of the neck, multiparametric ultrasound examination of the thyroid gland, including B – mode, color Doppler mapping, compression elastography, shear wave elastography, laboratory examination (calcitonin level, TSH, T3, T4, antibodies of TPO, AtTTP, thyroglobulin). In patients who had previously undergone surgical treatment, ultrasound was performed to determine areas of thyroid tissue, and additionally the level of thyroglobulin was determined as a marker of the recurrent process.Results. The median size of the thyroid formation was 15.2 (13.9–19.1) mm. Mainly multiple foci of thyroid gland were detected in both the control group – 106 (79.1%) and the main 107 (54.3%) patients, the share of single foci accounted for 28 (20.9%) of the control and 90 (45.7%) of the main groups. Fine – needle aspiration biopsy was performed using the «Free hand» method using type syringe with a volume of 10 ml. During the vacuum fine – needle aspiration biopsy, depending on the data of the multiparametric ultrasound examination, the level of negative pressure in the range from –0.3 bar to –0.8 bar was determined. At a pressure of –0.3 bar, 54 (27.4%) were performed,–0.5 bar – 126 (64.0%),–0.8 bar – 17 (8.6%) vacuum fine – needle aspiration biopsy.Conclusions. A device has been developed for the implementation of vacuum fine – needle aspiration biopsy with the creation of an improved technique for conducting vacuum fine – needle aspiration biopsy in focal thyroid pathology. The informative value of the method of routine fine – needle aspiration biopsy and vacuum fine – needle aspiration biopsy under ultrasound control in patients with focal thyroid pathology was evaluated. The sensitivity and specificity of fine – needle aspiration biopsy was 75.0% and 52.9%, respectively. The sensitivity and specificity of vacuum fine – needle aspiration biopsy during the study were 95.6% and 92.5%, respectively. The data obtained indicate the effectiveness ","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.33667/2078-5631-2024-6-58-62
A. Yakovleva, A. Shestopalov, I. Dolgov
Patients with severe brain damage often develop pressure ulcers (PU). The phases of the wound process significantly extend in time due to the underlying disease, severity of the condition and metabolic changes. Medical thermal imaging can be used to assess the level of PU microcirculation.Aims: to study the possibility of using medical thermal imaging to predict the course of PU in patients after severe brain damage.Methods: 38 ICU patients after brain injury and stage III–IV PU (25 men, 13 women, mean age 59±17 years). The series of thermograms (native image, after the “cold test” and 3 minutes after) were recorded before treatment and after 21 days. We used an NEC ThermoTracer TH 9100 thermal imager.Results. We assessed the minimum/maximum overall temperatures and in the 1st–4th quartiles. With a positive outcome, the temperatures Q3-Q4 were higher (35.1 C–37.6 C versus 34.8 C–36.7 C for a negative outcome) and the lower thresholds of all quartiles. We hypothesized that a sign of PU healing is a narrowing of the range of temperature points on the surface of the wound. We used a point system for assessing the dynamics of temperature parameters, then checked the model using ROC analysis: the AUC was 0.932 (0.81–1.0), which indicates the high quality. The best ratio of sensitivity and specificity (0.81; 0.83) corresponds to a cut-off point of 9.5.Conclusion. The use of medical thermal imaging makes it possible to objectively assess the level of blood supply to the PU in patients after severe brain damage, as well as the prognosis of further wound healing.
严重脑损伤患者经常会出现压疮(PU)。由于潜在疾病、病情严重程度和新陈代谢的变化,伤口过程的各个阶段在时间上会明显延长。医学热成像可用于评估压疮微循环水平。目的:研究使用医学热成像预测重度脑损伤患者压疮病程的可能性。方法:38 名重症监护病房脑损伤和 III-IV 期压疮患者(25 名男性,13 名女性,平均年龄 59±17 岁)。在治疗前和治疗 21 天后记录一系列热图(原始图像、"冷试验 "后和 3 分钟后)。我们使用的是 NEC ThermoTracer TH 9100 热成像仪。我们评估了整体温度的最低/最高值以及第 1-4 个四分位数。结果为阳性时,第 3-4 季度的温度较高(35.1 摄氏度-37.6 摄氏度,而结果为阴性时为 34.8 摄氏度-36.7 摄氏度),所有四分位数的阈值较低。我们假设 PU 愈合的标志是伤口表面温度点的范围缩小。我们采用积分系统评估温度参数的动态变化,然后使用 ROC 分析检验模型:AUC 为 0.932(0.81-1.0),表明模型质量很高。灵敏度和特异性的最佳比率(0.81; 0.83)与 9.5 临界点相对应。使用医用热成像可以客观地评估严重脑损伤后患者的 PU 供血水平以及伤口进一步愈合的预后。
{"title":"The use of medical thermal imaging in assessing the dynamics of healing of pressure ulcers in patients with severe brain damage","authors":"A. Yakovleva, A. Shestopalov, I. Dolgov","doi":"10.33667/2078-5631-2024-6-58-62","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-6-58-62","url":null,"abstract":"Patients with severe brain damage often develop pressure ulcers (PU). The phases of the wound process significantly extend in time due to the underlying disease, severity of the condition and metabolic changes. Medical thermal imaging can be used to assess the level of PU microcirculation.Aims: to study the possibility of using medical thermal imaging to predict the course of PU in patients after severe brain damage.Methods: 38 ICU patients after brain injury and stage III–IV PU (25 men, 13 women, mean age 59±17 years). The series of thermograms (native image, after the “cold test” and 3 minutes after) were recorded before treatment and after 21 days. We used an NEC ThermoTracer TH 9100 thermal imager.Results. We assessed the minimum/maximum overall temperatures and in the 1st–4th quartiles. With a positive outcome, the temperatures Q3-Q4 were higher (35.1 C–37.6 C versus 34.8 C–36.7 C for a negative outcome) and the lower thresholds of all quartiles. We hypothesized that a sign of PU healing is a narrowing of the range of temperature points on the surface of the wound. We used a point system for assessing the dynamics of temperature parameters, then checked the model using ROC analysis: the AUC was 0.932 (0.81–1.0), which indicates the high quality. The best ratio of sensitivity and specificity (0.81; 0.83) corresponds to a cut-off point of 9.5.Conclusion. The use of medical thermal imaging makes it possible to objectively assess the level of blood supply to the PU in patients after severe brain damage, as well as the prognosis of further wound healing.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}